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Provider-Based Compliance Now More Critical Than Ever

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Provider-Based Compliance Now More Critical Than Ever

Provider-based compliance for hospitals is now more important than ever. The Bipartisan Budget Act of 2015 has dramatically changed the provider-based regulatory landscape and underscores the importance of full compliance for provider-based sites.

The primary means for ensuring regulatory compliance is through the provider-based attestation process. The attestation process culminates with CMS’s approval and acknowledgement that a site meets the provider-based regulations. CMS’s approval protects facilities against any increased scrutiny that may accompany the new regulation, and also serves to insulate a provider from retroactive reimbursement adjustments should CMS or its agents later determine that a provider-based facility was not in compliance with the regulations. Off-campus facilities currently billing as provider-based will be able to prove timely operational compliance to meet the “grandfather” exception, while on-campus facilities will be able to document compliance with location restrictions.

Undergoing the attestation process is an effective tool to implement necessary performance improvement initiatives. Moreover, this process will ensure providers are taking the correct steps to protect reimbursement under the Bipartisan Budget Act.

Murer Consultants, as a recognized expert in the field, offers the full service of attestation preparation and submission, as well as mock compliance audits. Murer is committed to prioritizing these provider-based assignments in light of the new legislation.

Please contact our office for more information at (708) 478-7030.

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